Anterior mandible canal communications: a potential portal of entry for tumour spread

Objectives: CT is often used to assess the fine anatomy of the anterior mandible. The objectives of this study were to (1) investigate the presence of communications between the inner and outer bone plates in this area, (2) localize these communications in relation to surgical–anatomical landmarks and (3) review the literature related to mandibular cancer invasion. Methods: CT images of 50 patients were used for the identification of the intrabony canals and for the localization of canalicular communications connecting the labial and lingual mandibular plates, in relation to the mental foramen. Results: Communications between the labial and lingual mandibular plates were found in 14 (28%) of 50 patients. These communications mainly appeared as a crossing of the lateral lingual with the incisive canal, but also as an extension of the median lingual canal to the labial plate. Conclusion: There is radiological evidence for the presence of a canalicular network bringing into communication the inner and outer bone plates in the anterior mandible. There are also indications that such a finding could assist in the better understanding of bone tumour invasion and spread. Further studies are required to verify and evaluate these findings.